The Use and Effectiveness of Mental Health Courts

Mental health courts (MHCs) have been created in jurisdictions across the United States because an increasing number of defendants have serious mental health conditions that are not being addressed effectively within the criminal justice system.1

According to Roger Boothroyd, PhD, of the Department of Mental Health Law and Policy of the University of South Florida in Tampa, MHCs have specific characteristics that differentiate them from traditional courts. MHCs are exclusive to individuals with serious and persistent diagnosable mental health illness. These courts are intended to divert individuals with mental health illness from the criminal justice system and into a treatment system, with the goal of reducing future offenses and recidivism.

In addition, these courts provide mandated community health treatment (often instead of jail) and ongoing judicial status review hearings. They operate using voluntary enrollments that are reliant upon both administrative referrals and participant consent.
According to the Adult Mental Health Treatment Courts Database 2013, there are currently 343 different adult mental health courts operating in 43 states, Boothroyd said.2

However, MHCs are operated by counties, rather than states.
“One of the features of these courts is that they are highly variable within states and across states. The federal government does not fund mental health courts, so there is no standard protocol for setting them up or running them,” said Henry Steadman, PhD, president of Policy Research Associates, which provides training and technical assistance workshops to improve mental health delivery.

Steadman, who has conducted much research on mental health and the criminal justice system, also spent 17 years directing a research bureau at the New York State Office of Mental Health.

Mental Health Illnesses and Crimes Addressed Varies

The lack of state and federal funding means MHCs rely heavily upon the services available within the community. According to Steadman, most mental health courts do not have treatment services as part of the court. The court has to broker services with nonprofit organizations. They have to arrange for services within the community, which dictates the mental health conditions they can address.

“Regardless of diagnostic category, the most common feature of mental illnesses seen in mental health courts is co-occurring substance abuse disorder. However, all courts do not take all disorders. It depends on the court and access to treatment within the community,” Steadman said.

The types of crimes addressed in these courts also vary depending on services available within the community.
“The crimes handled in mental health courts vary widely. The majority focus on misdemeanors and low-level crimes and a lot of drug charges, as most patients have co-occurring substance abuse disorders combined with their mental illness,” Steadman added. “However, other courts focus only on felonies, including assault cases as well as higher-level drug charges. Overall, crimes against person are less frequent.”